fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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Oh, Susanna

Susanna came into the U.S. fighting the mosquito-borne viral disease chikungunya. Her thin body, wracked with fever, shivered and fought off the infection; her family back in her home country called around for a PCP who would see her. They found me and scheduled an appointment. I knew the signs and symptoms of chikungunya, and I knew the hard mass I felt in her belly was something else.

She was diagnosed with cancer two days later and started chemotherapy as soon as she recovered from her infection.

She lost weight from both illnesses, and I continued to marvel at how she tolerated the harsh medications as well as her illnesses.

A few months later, she told me she was going back to her home country to seek warmth and family and food. I was not sure if we would see her again, but she came back to the emergency department with a rash on her thigh. It was initially diagnosed as shingles but turned out to be an aggressive case of skin cancer. She got surgery and chemotherapy again.

The skin cancer came back on her nose, and she needed scalpels and medicines one more time. Amidst this tumult, she shuttled between her family abroad and her home here, grappling not only with cancer but also uncontrolled diabetes, tuberculosis, malnutrition, and all the challenges they brought. Her journey mirrored a winding road punctuated by formidable speed bumps.

Her concern is always on her medication refills. She travels home, runs out of medicines, and returns with all her tests abnormal. By the time we get her back on her meds, she’s heading home again. I now understand the pattern well. I worry but acknowledge her noncompliance, recognizing it as the cadence of her life.

Yet I am most in awe of Susanna’s resolute mind; despite her complicated treatment regimens, she has decided that she will not take injections—they hurt too much. Countless discussion, interpreters, and family members have failed to change her mind. She has accepted her cancer diagnosis, embraced a new way of life, adapted to a new diet, and endured cold weather, but she refuses to accept injectable medications.

Oh, Susanna, I am in awe of your unyielding determination, of the way you speak your mind and assert your control over your choices in the midst of life’s challenges.

Nidhi Lal
Acton, Massachusetts


1 thought on “Oh, Susanna”

  1. This is such a powerful reminder of honoring a patient’s autonomy, Nidhi. It also values the complexities of Susanna’s diagnoses and her social network of support across continents. Susanna is not someone to be cured but celebrated for her ‘unyielding determination’.

    Thanks for sharing this story. May you continue to mirror each patient’s dimensionality beyond diagnoses.

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